Findings from a new study have shown an under-recognised bacteria source – the hospital floor – that highlights the need for improved infection control procedures.
According to the study, published in the journal Infection Control & Hospital Epidemiology, hospital room floors are contaminated with antibiotic-resistant bacteria within hours of patient admission. The researchers highlight how this creates a route of transfer of potentially dangerous organisms to patients.
The dangers of hospital room floors
The researchers from the Northeast Ohio VA Healthcare System tracked contamination in hospital rooms of 17 newly admitted patients to identify the timing and route of transfer of bacteria within the rooms. The rooms were thoroughly cleaned and sanitised before testing, and all patients also screened negative for methicillin-resistant Staphylococcus aureus (MRSA) and other healthcare-associated bacteria.
The patients’ interactions with healthcare personnel were then observed, along with portable equipment, and collecting cultures one to three times per day from patients, their socks, beds, and other high-touch surfaces, as well as key sections of the floor.
Curtis Donskey, MD, senior author of the study and hospital epidemiologist at the Cleveland VA Medical Center, said: “If bacteria stayed on floors this wouldn’t matter, but we’re seeing clear evidence that these organisms are transferred to patients, despite our current control efforts. Hand hygiene is critical, but we need to develop practical approaches to reduce underappreciated sources of pathogens to protect patients.”
Findings from the study demonstrated that nearly half of the hospital rooms tested positive for MRSA within the first 24 hours, and MRSA, C. difficile, and vancomycin-resistant enterococci (VRE) pathogens were identified in 58% of patient rooms within four days of admission. They also highlighted that contamination often started on the floors, but moved to patients’ socks, bedding, and nearby surfaces.
“While we’re showing that these scary sounding bugs can make their way into a patient’s room and near them, not everyone who encounters a pathogen will get an infection,” said Sarah Redmond, lead author and a medical student at Case Western Reserve University School of Medicine. “With that in mind, are there simple ways to address these areas of exposure without placing too much emphasis on the risk?”
COVID-19 on hospital floors
The authors have published a related study in the journal that showed regular detection of COVID-19 (SARS-CoV-2) nucleic acid on the floors, and on the shoes of personnel in COVID-19 wards, noting that more research is needed to clarify how hospital floors contribute to the transmission of pathogens.
They also highlighted further research needs to be done to identify more practical approaches to address these contamination issues, as contamination on COVID-19 wards were reduced with simple changes to floor cleaning and disinfection protocols.
Several limitations of the study were noted, including the small sample size and variables in characteristics among patients and healthcare personnel that may impact how generalisable the study findings are to other hospitals.